Prestige vs. Happiness

[FOREAL]

HI everyone,

I do apologize in advance if this topic has come up before. I am new to
SDN and I have learned alot from the posts that I have read. So I am posing a very important question to you all and very much interested to know your thoughts:

When it comes to choosing your program/ROL, alot of people have said that they should devise their ROL based on what programs would be the 'best fit' for them. What does this really mean? I am finding that in my conversations with my fellow classmates (MSIVs) that prestige is the predominant factor in their ROL.

HOwever in my situation, as much as I want a prestigous program for obvious reasons, happiness is extremely important to me. In many posts, people have mentioned that the 'top' programs have miserable residents. Is this across the board? Is this to be expected? I mean really...if its a top program are you expected to work your @$$ off and be happy. Whereas in the not-so-top programs tend to have happy residents.

Its also interesting to see that alot of interns I know talk about happiness as THE MOST important factor and yet they simply cant deny the fact that going to a prestigous programs can put your foot in door for so many great opportunities.
For me, ideally, I would like both.

So truthfully...what is it for you... happiness or prestige?

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[THP]

HI everyone,

I do apologize in advance if this topic has come up before. I am new to
SDN and I have learned alot from the posts that I have read. So I am posing a very important question to you all and very much interested to know your thoughts:

When it comes to choosing your program/ROL, alot of people have said that they should devise their ROL based on what programs would be the 'best fit' for them. What does this really mean? I am finding that in my conversations with my fellow classmates (MSIVs) that prestige is the predominant factor in their ROL.

HOwever in my situation, as much as I want a prestigous program for obvious reasons, happiness is extremely important to me. In many posts, people have mentioned that the 'top' programs have miserable residents. Is this across the board? Is this to be expected? I mean really...if its a top program are you expected to work your @$$ off and be happy. Whereas in the not-so-top programs tend to have happy residents.

Its also interesting to see that alot of interns I know talk about happiness as THE MOST important factor and yet they simply cant deny the fact that going to a prestigous programs can put your foot in door for so many great opportunities.
For me, ideally, I would like both.

So truthfully...what is it for you... happiness or prestige?

I guess it depends on if your happiness is based on prestige. Many medical students crave prestige and happiness cannot be separated from it.

 

[PatrickBateman]

I guess it depends on if your happiness is based on prestige. Many medical students crave prestige and happiness cannot be separated from it.

These idiots you speak of have no real understanding of what happieness is. This is the reason why it's pointless to ask about "malignancy" at a malignant program. Most of the people there have no understanding of what the term means. You won't get an insightful answer. It's like asking someone "tell me all about your psychological blind spot".


Personally, I'm interested in high quality training in a NON STUFFY atmoshpere. But I can tell you that prestige addiction is a tough habit to kick. It's insideous and seductive and difficult to resist. But it's possible.

 

[cytoborg]

Coming from a resident, it's a balance of happiness and quality. Often, a famous program has earned that reputation because they are truly a great program. In this whirlwind process of choosing a program based on 1-day visits and incomplete information, prestige is used as a marker for good training, and that's not entirely a bad thing. But there are a lot of quality programs out there, including some "sleeper" programs where their reputations haven't caught up yet so it's good to keep an open mind about the lesser-known programs as well. Of course, some quality programs will have happier residents than others, so by all means find one where you'll be happy, too (i.e. how do you mesh with the other residents, what is the work environment like, do you like the geographic location and city, could you afford to live there, etc).

A word of caution: to get a quality education during residency, you do have to work hard, see a lot, and do a lot, and sometimes that is not so fun. I met happy residents at programs where the hours are light, the attitude is kick-back, they have plenty of free time and of course they love that. But the flip side was that they were simply not seeing and doing very much. Not good. On the other hand I saw one big-name program where the residents were miserable and for that reason I ranked that program low, too. I was lucky enough to end up at a program that is considered prestigious, that I felt to be a quality program, AND the residents are happy. We do work hard and at times it can be intense, but it's great experience, and overall we are happy and have fun.

 

[PatrickBateman]

Coming from a resident, it's a balance of happiness and quality.

Eh, I don't think you need to be a resident to work that out, genius.

 

[cytoborg]

Eh, I don't think you need to be a resident to work that out, genius.

Huh? I don't follow.

 

[CTKN2]

This is a very interesting topic, and I'm having the same debate with myself between happiness and prestige. I would like to think that I would choose happiness over prestige, but there's that little competitive part of me that wants the brand name too. There are definitely awesome programs out there that give you both a high quality of training and have the prestige associated with it - and that's great. But those programs are hard to get into. There are many more programs out there that are going to give you a great quality training. In the end (and more realistically) I think I'm going to place a lot more weight on quality of education/training instead of prestige and then balance that with happiness.

 

[Poety]

what about if you shine at a smaller program and get recognized for it more readily than if you are just another resident that went to Harvard? I'm just asking here - do you think maybe they could equal eachother out in the long run?

 

[AngryTesticle]

what about if you shine at a smaller program and get recognized for it more readily than if you are just another resident that went to Harvard? I'm just asking here - do you think maybe they could equal eachother out in the long run?

But see, if you go to a less reputable program, you HAVE to shine. Whereas, if you're at a place like Harvard, you can just carry on and have many opportunities open up for you.

The "happiness" camp will say things like "you make your own prestige." Goddamnit, I don't wanna. I'm too lazy. I want **** handed to me.

 

[neilc]

i chose a smaller program, certainly not a brand name over some solid university programs. (granted, i signed outside of the match, and will never know if i really would have matched at these places...but, i had very good feedback and emails of regret when i advised that i would be withdrawing myself from consideration).

but, my perspective was this. what do i really gain from the "brand name" places? i am not shooting for fellowship or an academic carreer. i know the training is excellent at many smaller community programs for generalist ob/gyn. so, i felt it was more important to me to join a program that felt close, and to live in an area that i will enjoy and be able to comfortably afford.

it is really a matter of priorities, and there are lots of good reasons to go with a more prestigious program. but, if you are thinking of a brand name program simply because you are competitive, you may be missing out on a great program where you will be happpy. if you don't need the benefits of a brand name, go with the happiness.

 

[me454555]

The answer to this question is always happiness. The real question is where you derive your happiness from? Will you be happiest b/c you've gone to a prestigous place even if you have to work long hours or will you be happier at a smaller tight knit place? Theres even the possibility you will be happy by working the least amount of hours possible and getting a lot of time to yourself and read. You're the only person who can ake this decision

 

[beary]

But see, if you go to a less reputable program, you HAVE to shine. Whereas, if you're at a place like Harvard, you can just carry on and have many opportunities open up for you.

This is a really interesting point and I have never thought of it exactly that way before. I am struggling with some of these decisions as well on the interview trail. I tend to be in the "happiness" camp (to a certain extent, as long as you are at a decent institution and get good training) but you make a good point to go for "prestige."

 

[Poety]

i chose a smaller program, certainly not a brand name over some solid university programs. (granted, i signed outside of the match, and will never know if i really would have matched at these places...but, i had very good feedback and emails of regret when i advised that i would be withdrawing myself from consideration).

but, my perspective was this. what do i really gain from the "brand name" places? i am not shooting for fellowship or an academic carreer. i know the training is excellent at many smaller community programs for generalist ob/gyn. so, i felt it was more important to me to join a program that felt close, and to live in an area that i will enjoy and be able to comfortably afford.

it is really a matter of priorities, and there are lots of good reasons to go with a more prestigious program. but, if you are thinking of a brand name program simply because you are competitive, you may be missing out on a great program where you will be happpy. if you don't need the benefits of a brand name, go with the happiness.

CONGRATULATIONS NEIL!!! i didn't know you matched already!!! YEAH!


edit: Also, does anyone know how to tell apart the non-prestigious institutes? I mean I applied to the big boys, got like one interview But for the most part I'm interviewing at what I would think are mid tier? But I'm not sure - maybe they're low tier, how do I know? Is there some place to find this stuff out? They are all smaller programs which I prefer to big boy programs

 

[sophiejane]

But see, if you go to a less reputable program, you HAVE to shine. Whereas, if you're at a place like Harvard, you can just carry on and have many opportunities open up for you.

The "happiness" camp will say things like "you make your own prestige." Goddamnit, I don't wanna. I'm too lazy. I want **** handed to me.

Wow, that's scary. Hopefully that was sarcasm, but I know there are people who really think that way.

I know that I learned all the same stuff that people who went to Ivy U. learned in medical school. But I would never dream of slacking away my residency. There's too much more to learn, and the stakes are too high.

Mediocrity--no matter where you train--will get you nowhere (except into a courtroom where you are the defendant) and the big name on your diploma will only carry you so far when you start losing patients because you suck.

 

[AngryTesticle]

Wow, that's scary. Hopefully that was sarcasm, but I know there are people who really think that way.

I know that I learned all the same stuff that people who went to Ivy U. learned in medical school. But I would never dream of slacking away my residency. There's too much more to learn, and the stakes are too high.

Mediocrity--no matter where you train--will get you nowhere (except into a courtroom where you are the defendant) and the big name on your diploma will only carry you so far when you start losing patients because you suck.

I'm glad you picked up on the sarcasm. Especially the last sentence of my post. Sometimes when topics like these come up, I do like to play devil's advocate with a sarcastic tone...

Now, let me put my serious hat back on. Whoever said that at the "top programs" you work hard is absolutely right. There is commonly the mentality that "oh son, you should feel privileged to be here; now do all this work!" Getting good training does come at a price. You lose sleep. You lose time with your family. You're in the hospital a lot. BUT, you see a lot! You know, it was funny...apparently the anestheliologists and radiologists were flabbergasted to know that we pathology residents here go over 80 hours on some weeks. Well yeah, that's cuz we see a truckload of cases.

The only ounce of seriousness in my previous post was that at "top programs" it is harder to shine because your colleagues are also of very high caliber. Do you want to be a big fish in a little pond? Or do you want to be a little fish in a big pond? Personally, I feel like the latter because a lot of my colleagues here are very very good. It's never about competition here and I'm perfectly happy being the little fish in a big pond even while doing a solid job at work. And I've heard of plenty of stories where the good resident, who isn't the best in the program per se, outcompetes the "shining star" residents from lower caliber programs for jobs just by the nature and quality of the training we have had and the professional connections we have. Yeah, it sounds pompous. But that's how it works in the real world.

How do you define "shine"? Outdoing your classmates? Or simply doing a good job at work and learning what you need to learn? Because if you're in the latter camp of thought, then almost everybody here shines. Now, if you're in the former camp of thought, then yes I guess I can call myself lazy. I'm not going to go the extra mile to out-do my classmates and do all sorts of extra work so that faculty see me as the best resident. That's just stupid.

 

[AngryTesticle]

This is a really interesting point and I have never thought of it exactly that way before. I am struggling with some of these decisions as well on the interview trail. I tend to be in the "happiness" camp (to a certain extent, as long as you are at a decent institution and get good training) but you make a good point to go for "prestige."

Don't feel like I'm pointing fingers at you cuz that is not my intention when I say this. I have a real problem with people dichotomizing prestige and happiness like it's some sort of yin-and-yang or black-and-white type of contrast. You CAN go to a place where there is a significant prestige factor AND you are happy.

I fully agree with you with regards to your last sentence. I always felt that you need to get good training. Now, some people associate happiness with working little. Then some people define happiness with working a lot and seeing a ton of fantastic cases. Some people, like me, are in the middle. What makes me happy is that there are plenty of good learning opportunities but that I have balance in my life with respect to work and free time. It's fun to work hard and play hard at the same time.

Happiness is important but prestige should not be ignored completely because that stuff CAN and often will matter when you're vieing for some jobs, especially academic jobs.

 

[DrNick2006]

80 hours a week is 80 hours a week. Is it filled with scut or learning?

what are your goals? Academia, research, teaching, clinical practice? Go to a program that will meet these goals. Makes no sense to go to MGH if you only want to work 50 hours a week as a family doc in rural america, you won't learn that at MGH.

Whats it worth to be in the loop? Name brands are more expensive because people buy them.

prestigous programs are such because they are usually better, have seen both and you definantly can see a difference.

Most people are not mean anywhere you go, after all, we are all physicians not lawyers

How do you feel at a program with the people, with the city. Should be a good feeling. IF you cant feel good after one day how will you feel after 6 months - miserable.

 

[southerndoc]

Always go for happiness, but for some people happiness is only with prestige. What is it you crave?

 

[FOREAL]

As it turns, my future plans are not as concrete as some of my fellow classmates. As for the field of medicine...pediatrics all the way. However I have thought about the world of academia and have definitely thought about and have already done international work (like the WHO)

I guess I have big dreams but I am also a realist...Knowing that prestigous programs can get your foot in the door. I dont intend on slacking off where ever I go, simply for the sake of my patients. Besides I dont want anyone slacking off on my brother, mother, father, etc.

I do agree that one does not necessarily have to separate prestige from happiness. I think, for me, it boils down to a genuine fear of being/or feeling and 'lost' in a big prestigous program, especially coming from a small school. Although I welcome the challenge, I am also very much aware of what you have to do to prove that you do belong. My experience in med school and overseas has been very humbling for me. With that said, I am not particularly excited about dealing with egos. So as much as I would like to attend a prestigous program which would make me happy, the other part is the atmosphere that I have yet to experience (an 7-8hr interview is not sufficient, especially when everyone is putting their best mask on)